* Required

Loomis Chaffee Contractor Registration Form

The above-named contractor hereby certifies:

1. It is in compliance, and will continue to comply, with the requirements set forth in Connecticut General Statutes § 10-222c(g) with respect to any employee who would be in a position involving direct student contact at the Loomis Chaffee School (the “School”). The Contractor shall require any employee who would be in a position involving direct student contact to supply all information required of an applicant under Connecticut General Statutes §§ 10-222c(a)(1)(A) and (C), and written authorization under § 10-222c(a)(1)(B), to the Contractor via a completed State of Connecticut Contractor Verification Form and Applicant Release PA 16-67. The Contractor shall contact any current or former employer of such employee that was a local or regional board of education, council, school operator, or supervisory agent, or if such employment caused the employee to have contact with children, and request information concerning whether there was a finding of abuse or neglect or sexual misconduct against such employee.If the Contractor receives any information indicating such a finding, or otherwise has knowledge of such a finding, the Contractor shall immediately forward such information to the School. And;

2. With respect to any individuals, employees, subcontractors, or other agents (collectively, “employees”) it brings on site to perform work at the School: (a) Such employees have never been convicted of a crime and do not have any pending criminal charges. (b) State and national criminal history records checks have been completed within the past twelve (12) months. The cost of any criminal history record check for such shall be the sole responsibility of the Contractor. The School reserves the right to audit such criminal history checks as it deems appropriate. (c) If the Contractor becomes aware of any new criminal charges or convictions of any such employee, it will notify the School’s Director of Campus Safety and the Director of Physical Plant immediately.

Determination by the School that an employee may not work under any such contract, in any position, shall not constitute a breach of contract.

In the event that the Contractor brings any individuals, employees, subcontractors, or other agents onto the grounds of the School in violation of this Agreement, any future opportunities for the Contractor to do work at the School will be forfeited.

This form will be submitted to Chris Lamy, Director of Campus Safety at chris_lamy@loomis.org